涂阳肺结核患者密切接触者结核感染危险及相关因素分析

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目的研究探讨涂阳肺结核患者密切接触者感染肺结核的危险率及其相关影响因素。方法本次实验选取2014年10月——2015年10月以本区确认与涂阳肺结核患者有密切接触的8 176例接触者为研究对象,安排所有患者进行常规检查,其中有卡痕患者390例,本研究针对无卡痕的7 786例接触者进行实验研究,进行两次PPD试验,间隔时间为4个月,分析其危险率及相关影响因素。计数资料用χ~2检验,P<0.05为差异有统计学意义。结果感染率随着年龄的变化有所变动,且<15岁感染率最低,为30.3%,35~44岁感染率最高,为66.8%。肺结核患者痰液中的结核杆菌含量愈多,其接触者的感染率及强阳性率愈高,两者之间呈正相关关系,这表明肺结核患者中痰液的结核杆菌含量是其接触者感染肺结核的独立风险因素。患者确诊前症状持续时间<1个月的接触者感染率最低,患者确诊前症状持续时间与接触者阳性率之间对比差异无统计学意义(P>0.05),但与PPD试验强阳性率之间对比差异有统计学意义(P>0.05),患者确诊前症状在≥1个月以上的接触者的强阳性率之间对比差异无统计学意义(P>0.05)。涂阳肺结核患者密切接触者结核的年感染危险率为3.44%。结论涂阳肺结核患者密切接触者结核的年感染危险率高于普通人,且与年龄有一定关系,且肺结核患者中痰液的结核杆菌含量是其接触者肺结核感染率的独立的风险因素。 Objective To study the risk of tuberculosis in close contact with smear positive pulmonary tuberculosis patients and its related factors. Methods From October 2014 to October 2015, we selected 8176 contacts who had close contact with smear-positive pulmonary tuberculosis patients in this area as the research object, and arranged all the patients for routine examination. Among them, patients with keloid 390 In this study, 7 786 contactless patients without card marks were studied in this study. Two PPD tests were conducted at an interval of 4 months. The risk factors and their related factors were analyzed. Count data with χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The infection rate varied with age. The lowest infection rate was 30.3% at <15 years and 66.8% at 35-44 years. Tuberculosis patients with sputum more Mycobacterium tuberculosis, the contact rate of infection and the strong positive rate, the higher the positive correlation between the two, indicating that sputum tuberculosis in patients with tuberculosis is contagious contact with tuberculosis The independent risk factors. There was no significant difference in contagion rate between the duration of symptom onset and the positive rate of contact before the diagnosis (P> 0.05), but the positive rate of PPD was There was significant difference between the two groups (P> 0.05). There was no significant difference in the positive rate of the patients with symptoms more than 1 month before diagnosis (P> 0.05). The risk of annual infection of tuberculosis in close contact with smear positive pulmonary tuberculosis patients was 3.44%. Conclusions The annual risk of infection of tuberculosis in close contact with smear positive pulmonary tuberculosis patients is higher than that of common people and has a certain relationship with age. The tuberculosis bacilli of sputum in pulmonary tuberculosis patients are independent risk factors of tuberculosis infection in their contacts.
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